五苓逍遥散治疗中心性浆液性脉络膜视网膜病变的临床评估

摘要

目的 探讨五苓逍遥散对水湿上泛型中心性浆液性脉络膜视网膜病变(CSC)的临床疗效.方法 采用随机对照方法,将47例(51只眼)水湿上泛型中心性浆液性脉络膜视网膜病变患者分为对照组22例(23只眼)和治疗组25例(28只眼).对照组给予复方樟柳碱注射液颞浅动脉旁注射,2 ml/次,1次/d.治疗组在上述治疗的基础上,口服五苓逍遥散.3个月后,观察两组患者的总体疗效及视力、视野平均缺损(MD)和黄斑区视网膜厚度的变化情况.结果 治疗组临床治愈6例(7只眼)(24.0％),显效8例(8只眼)(32.0％),好转6例(7只眼)(24.0％),无效5例(6只眼)(20.0％),有效率为80.0％;对照组患者临床治愈3例(3只眼)(13.6％),显效3例(4只眼)(13.6％),好转7例(7只眼)(31.8％),无效9例(9只眼)(40.9％),有效率为59.1％.组间差异有统计学意义(Z=1.8762,P=-0.0303).治疗后两组患者的视力、视野MD均较治疗前改善(P＜0.05),黄斑中央1 mm、6 mm范围平均厚度及黄斑容积均较治疗前降低(P＜0.05),治疗组各项指标结果好于对照组(P＜0.05).结论 五苓逍遥散对水湿上泛型CSC有较好疗效,可以有效改善患眼视功能,并促进病变区域形态的恢复.%OBJECTIVE To investigate the clinical efficacy of Wuling Xiaoyao powder on central serous chorioretinopathy (CSC) in water-dampness flood upward syndrome (WDFUS).METHODS According to randomized controlled scheme,47 CSC cases in WDFUS were randomly divided into control group and treatment group.The control group included 22 cases (23 eyes),while treatment group consisted of 25 cases (28 eyes).Patients in control group received injectious of 2ml compound anisodine besidc superficial temporal artery,once a day.Based on the above methods,patients in treatment group were given oral Wuling Xiaoyao powder twice a day.After 3 months,the overall curative effect,visual acuity,mean defect of visual ficld and the OCT in both groups were measured and evaluated.RESULTS In the treatment group,7 eves of 6 cases (24.0％) were clinically cured,8 eyes of 8 cases (32.0％) were markedly effective,7 eyes of 6 cases (24.0％) were improved,6 eyes of 5 cases (20.0％) were invalid,the effective rate was 80.0％.In the control group,3 eves of 3 cases (13.6％) were clinically cured,4 eyes of 3 cases (13.6％) were markedly effective,7 eyes of 7 cases (31.8％) were improved,9 eyes of 9 cases (40.9％) were invalid,the effective rate was 59.1％.The difference between the two groups was statistically significant (Z=1.8762,P=0.0303).Compared with parameters before treatment,the vision and mean defect of visual field in two groups were statistically significantly increased while the thickness of 1 rmm.6 mm radius around central macula as well as total macular volume all decreased significantly (P＜0.05).In addition,result of indexes mentioned above in treatment group were better than counterparts of control group.CONCLUSIONS Wuling Xiaoyao powder had favorable effects on central serous chorioretinopathy in water-dampness flood upward syndrome in that it improved visual acuity and promoted the recovery of lesion.